Catheterization is a procedure in which a catheter is inserted in to the vasculature and navigated to a desired target location in the cardiovascular system for the purposes of delivering therapy or diagnosis. For example in the treatment of atrial fibrillation, as a typical application, an ablation catheter would be introduced to the vasculature and navigated to the left atrium to deliver RF ablation to desired anatomical locations in order to electrically isolate the source of arrhythmia from the rest of the heart.
Catheterization is conventionally guided by fluoroscopy. Fluoroscopy provides two-dimensional projections of the anatomical site, but low soft tissue contrast and the potential for spread of harmful radiation are undesirable aspects of conventional fluoroscopy-guided catheterization. Radiation spread is particularly a hazard for interventionalists who perform this procedure for prolonged periods of time on a daily basis. In contrast to fluoroscopy, Magnetic Resonance Imaging (MRI) is a safe imaging modality that offers superior soft-tissue-contrast, allows for 3D visualization and allows for monitoring of temperature elevations as well as the potential of identifying infarct and ischemic tissue. A challenge to MRI guided catheterization, however, is that the bore of conventional closed-bore MRI scanners is smaller and greatly limits patient access, which can hinder many procedures.
Conventional catheterization systems are commercially available, in which a catheter is driven by a robot or other remote device. Most conventional remote catheterization systems have the ability to manipulate a catheter with 2 degrees of freedom. Some remote catheterization systems have the ability to manipulate a catheter with 3 degrees of freedom. Neither of these systems, however, is appropriate for use in MRI settings, due to the magnetic materials of which they are made.
Some conventional catheterization systems are unable to accept catheters of various standard sizes, and must be used with catheters specific to the particular system. Among those that do accept standard-sized catheters, often only one standard size can be manipulated by the robot.
Furthermore, in many conventional systems, the motor itself moves with the catheter. This can restrict range of motion and also be detrimental in systems for use in, for example, MRI settings, in which operating space is relatively small and magnetic and current-carrying components should be kept out of some regions.
A system that allows for remote manipulation of a conventional patient catheter is therefore needed. Such a system should be fully non-magnetic, and should be configured for use in remotely navigating a conventional off-the-shelf catheter under the guidance of conventional fluoroscopy images and electromagnetic tracking systems, or inside the bore of an MRI scanner during MR imaging.